糖尿病合并尿路感染病原特征及影响因素分析  

Pathogenic characteristics and influencing factors of diabetes complicated with urinary tract infection

作　　者：陈仲钰 陈丹 江培涛 CHEN Zhong-yu;CHEN Dan;JIANG Pei-tao(Yizheng Hospital of Nanjing Gulou Hospital Group,Yangzhou City,Yangzhou 211900,Jiangsu,China)

机构地区：[1]江苏省扬州市南京鼓楼医院集团仪征医院,江苏扬州211900

出　　处：《中国病原生物学杂志》2022年第2期212-215,219,共5页Journal of Pathogen Biology

摘　　要：目的分析糖尿病合并尿路感染病原特征及影响因素,指导临床抗感染防治。方法收集糖尿病患者临床资料,对患者进行尿路感染诊断。收集患者尿液样本,对病原菌进行培养、鉴定。药敏试验采用纸片扩散法。采用质粒提取试剂盒提取大肠埃希菌质粒,PCR扩增耐药基因。统计分析患者感染相关因素。结果1013例糖尿病患者尿液标本中分离出革兰阴性菌108株(54.55%),革兰阳性菌74株(37.37%),真菌16株(8.08%)。革兰阴性菌中,大肠埃希菌45株、肺炎克雷伯菌37株、鲍曼不动杆菌18株、其他革兰阴性菌8株,分别占22.73%、18.69%、9.09%和4.04%;革兰阳性菌中,粪肠球菌30株、屎肠球菌22株、金黄色葡萄球菌16株、其他革兰阳性菌6株,分别占15.15%、11.11%、8.08%和3.03%;真菌中,白色假丝酵母菌10株,光滑假丝酵母菌6株,分别占5.05%和3.03%。45株大肠埃希菌对头孢吡肟、环丙沙星、哌拉西林、亚胺培南、阿米卡星、氨苄西林、庆大霉素的耐药率分别为40.00%、20.00%、48.89%、0.00%、8.89%、53.33%和24.44%;37株肺炎克雷伯菌对各抗菌药物的耐药率分别为27.03%、43.24%、48.65%、0.00%、13.51%、56.76%和21.62%;18株鲍曼不动杆菌对各抗菌药物的耐药率分别为33.33%、50.00%、77.78%、16.67%、33.33%、100.00%和66.67%。30株粪肠球菌对四环素、青霉素、氨苄西林、罗红霉素、环丙沙星、利福平、替考拉宁、万古霉素的耐药率分别为56.67%、16.67%、16.67%、56.67%、36.67%、50.00%、0.00%和0.00%;22株屎肠球菌对各抗菌药物的耐药率分别为63.64%、72.73%、63.64%、100.00%、68.18%、63.64%、0.00%和0.00%;16株金黄色葡萄球菌对各抗菌药物的耐药率分别为62.50%、75.00%、75.00%、25.00%、31.25%、6.25%、0.00%和0.00%。大肠埃希菌TEM、CTX-M-22、SHV、CTX-M-14、CTX-M-1、OTA-1、CTX-M-24和CTX-M-38的阳性检出株数分别为19、12、9、4、4、3、1和1株,阳性检出率分别为42.22%、26.67%、20Objective Pathogenic characteristics and influencing factors of diabetes complicated with urinary tract infection were analyzed to guide the prevention and treatment of clinical anti-infection.Methods Clinical data of diabetic patients were collected and urinary tract infection was diagnosed.Urine samples were collected for culture and identification of pathogenic bacteria.The paper diffusion method was used in the drug susceptibility test.Escherichia coli plasmids were extracted with plasmid extraction kit and the drug-resistant genes were amplified by PCR.The factors related to infection were analyzed statistically.Results There were 108strains of Gram-negative bacteria,74strains of Gram-positive bacteria and 16strains of fungi,with composition ratios of 54.55%,37.37%and 8.08%,respectively.Among the gram-negative bacteria,45strains of Escherichia coli,37strains of Klebsiella pneumoniae,18strains of Acinetobacter baumannii and 8strains of other Gram-negative bacteria accounted for 22.73%,18.69%,9.09%and 4.04%,respectively.Among the gram-positive bacteria,30strains of Enterococcus faecalis,22strains of E.,16strains of Staphylococcus aureus and 6strains of other Gram-positive bacteria accounted for 15.15%,11.11%,8.08%and 3.03%respectively.Among the fungi,10strains of Candida albicans and 6strains of Candida smooth accounted for 5.05%and 3.03%,respectively.The drug resistance rates of 45strains of Escherichia coli against cefepime,ciprofloxacin,piperacillin,imipenem,amikacin,ampicillin and gentamicin were 40.00%,20.00%,48.89%,0.00%,8.89%,53.33%and 24.44%,respectively.The drug resistance rates of 37strains of Klebsiellapneumoniaewere 27.03%,43.24%,48.65%,0.00%,13.51%,56.76%and 21.62%,respectively.The drug resistance rates of 18strains of Acinetobacter baumannii were 33.33%,50.00%,77.78%,16.67%,33.33%,100.00%and 66.67%,respectively.The drug resistance rates of 30strains of E.faecalis to tetracycline,penicillin,ampicillin,roxithromycin,ciprofloxacin,rifampicin,teicoplanin and vancomycin were 56.67%,16.67%,16.67%,56.67

关 键 词：糖尿病 尿路感染 病原特征 影响因素 

分 类 号：R378[医药卫生—病原生物学]